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GIT > Constipation > Flashcards

Constipation Flashcards

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1
Q

classification of drugs for constipation/laxatives/purgatives

A

laxative - expel formed stool
purgatives - expel watery stool

bulk laxatives
stimulant/irritative laxatives
osmotic laxatives
stool softeners
chloride secretors
miscellaneous

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2
Q

bulk laxatives / dietary fibres/ prebiotics

A

DOC for constipation (idiopathic/ pregnancy/ irritable bowel syndrome)

Psyllium (Metamucil)
Bran
Husk
Methyl cellulose
Ispaghula (Isabgol)

SE: increase bacterial growth (this prebiotics) which could lead to flatulence and increased ammonia which is absorbed into the blood

CI: paracytic ileus or megacolon

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3
Q

Stimulant or irritant laxatives

A

Bisacodyl
Senna
Cascara
Prucalopride (stimulates 5HT4)
Castor oil
Phenopthalein

use: constipation resistant to bulk laxative (idiopathic and IBS)
paracytic ileus
bowel evacuation before surgery or abdominal x-ray

CI: pregnancy (could lead to abortion)
spastic colony (abdominal pain)

SE: melanosis coli caused by Senna (contains black anthrol pigment)

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4
Q

Osmotic laxatives

A

saline purgatives (sodium phosphate)
non digestable sugars (mannitol,urea)
magnesium salts
poly ethylene glycol (DOC)
lactulose

DOC for whole bowel irrigation for colonoscopy/ before GIT surgery

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5
Q

Lactulose

A

reduces ammonia absorption from colony
use : laxative of choice in liver failure (hepatic encephalopathy)

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6
Q

hepatic encephalopathy

A

mild: lactulose (increase ammonia absorption)
severe: kill colonic bacteria
Rifaximin (overall DOC), Neomycin

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7
Q

Stool softener

A

Doccusate (DOSS)
Paraffin wax
Mineral oil - SE: could lead to aspiration pneumonia and foreign body granuloma

use: pregnancy, hernia patient,after abdominal surgery

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8
Q

Chloride secretors

A

Lubiprostone - PGE1 analogue - increase chlorine secretion
Linaclotide, Plecanatide - stimulates soluble guanylyl cyclase, stimulates CFTR - increase chlorine secretion

use: constipation in IBS

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9
Q

Sodium secretor

A

Tenapanor - inhibitor of Na+ H+ antiporter

new drug for constipation in IBS

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10
Q

laxative of choice in pregnancy

A

bulk laxatives > Doccusate

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11
Q

laxative of choice in liver disease

A

Lactulose

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12
Q

Miscellaneous laxatives and purgatives

A

Neostigmine - postoperative paracytic ileus

Erythromycin, Clarithromycin - stimulates motilin receptor - SE: hypertrophic pyloric stenosis

opioid induced constipation - Alvimopan

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GIT (4 decks)

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